Click to edit Master title style By France Bégin, Ph.D ... · nouveau-nés », selon l’Unicef ” “UNICEF Promosikan 'Brelfie', Dukung Menyusui di Ruang Publik” “How Important

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Protecting, promoting and

supporting breastfeeding By France Bégin, Ph.D.

UNICEF Nutrition NYHQ

Breastfeeding Seminar The TOPS Program

9-11 May 2017

The Science Prevalence of breastfeeding practices Enabling environment Community support Improving breastfeeding counselling Examples from selected countries Challenges Breastfeeding Advocacy Initiative Conclusions

OUTLINE

Prevent 800,000 child deaths annually

Significantly reduce neonatal mortality

Protect infants against deadly infectious diseases

Support brain development and increase IQ

Help prevent childhood overweight and obesity

Protect women against breast and ovarian cancers

Be environment-friendly

Reduce health care costs

What would you do if something could…?

Breastfeeding! 4

Improving breastfeeding would…

87% of them among infants less than 6 months of age

Reduce infection-related mortality (<3mo) by 88%

More than 54% of all diarrhea episodes And 32% of all respiratory infections prevented (in LMICs)

annually save lives of about 820,000 children U5

have a profound effect on common illnesses

Breastfeeding protects health and contributes to development

Breastfeeding also protects against: • Childhood obesity and type 2 diabetes Reduces risks of breast and ovarian cancers

Longer breastfeeding associated with higher performance on intelligence tests • Average of 3 IQ points, controlling for maternal IQ • Improved academic performance (some studies) • Increased adult earnings

Globally, less than half of all newborns are put to the breast within one hour of birth

Source: UNICEF global databases, 2016

Globally, just over two out of five infants are exclusively breastfed



The rate of exclusive breastfeeding declines steadily throughout the 0-5 month period in all regions

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Per cent of infants aged 0-5 months receiving breastmilk only, breastmilk and plain water, breastmilk and non-milk liquids, breastmilk and other milk/formula, breastmilk and complementary foods and no breastmilk, by region, 2016*

No breastmilk

Breastmilk and complementary foods

Breastmilk and other milk/formula

Breastmilk and non-milk liquids

Breastmilk and plain water

Breastmilk only


Globally, less than half of children are still breastfed at 2 years

Per cent of children 12-15 months of age who are breastfed, 2015t

Per cent of children 20-23 months of age who are breastfed, 2015t

Women face many barriers to breastfeeding

Rapid progress is possible

Increase in percentage of exclusively breastfed infants <6m

0

20

40

60

80

Niger (4) SierreLeone (5)

Kazakhstan(4)

BurkinaFaso (3)

State ofPalestine

(4)

Sudan (4) Kenya (5)

Baseline2005-09

Most recent2010-14

Mothers need support

BREASTFEEDING ADVOCACY INITIATIVE

Building an enabling environment for breastfeeding: A conceptual model

What can be done to have a world where all women are empowered and supported to breastfeed???

UNICEF for every child

Enabling environment – adequate national laws and policies

International Code of Marketing of Breastmilk Substitutes (BMS)

• Protects women from misinformation by prohibiting all advertising an promotion of BMS

• Prohibits the use of the health care system to promote BMS

National quality standards reflect baby-friendly standards

Maternity protection


Global status of legal measures in line with the Code in 2016

DRAFT Overview of monitoring and enforcement actions in UNICEF programme countries

NutriDash findings confirm that monitoring and enforcement of the Code are very weak

Enabling environment – Baby-friendly health facilities

• 10 Steps to Successful Breastfeeding • Recent systematic review (58 studies from 19

countries) shows positive impact of the 10 Steps on BF rates*

• Need to integrate into national policies and quality standards

• BFHI Guidance currently under revision

* Pérez-Escamilla, R., Martinez, J. L., and Segura-Pérez, S. (2016) Impact of the Baby-friendly Hospital Initiative on breastfeeding and child health outcomes: a systematic review. Maternal & Child Nutrition, 12: 402–417.



Skilled birth attendants can provide vital support for early initiation – we need to seize this opportunity

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* Per cent of newborns put to the breast within one hour of birth by birth delivery attendant, by region, 2015

Skilled birth attendant (e.g., doctor, nurse, midwife)

Untraditional birth attendant (e.g. traditional) or others (e.g., relatives) t

Marginally higher rates with skilled attendants

Marginally higher rates with unskilled/other

Rates about the same/no comparison available

Where is paid maternity leave available?


Breastfeeding in the workplace


Community support

Peer-to-peer support group

Mothers’ support group

Community mobilization

Use of mobile technology


Improving Breastfeeding counselling

• Greatest improvements in breastfeeding rates seen when counselling or education delivered in a combination of settings by involving health systems, home and family and the community environment concurrently.*

• Several issues related to breastfeeding counselling and support not addressed as specific recommendations in guidelines

• Guideline development on counselling and support for breastfeeding (WHO-UNICEF consultation, May 2017)

• Use of innovative technologies/videos

* Sinha B. Interventions to Improve Breastfeeding Outcomes: Systematic Review and Meta Analysis. Acta Paediatrica. 2015

GETTING THE WORD OUT IN THE MEDIA

“UN supports "brelfies" to encourage breastfeeding”

“New Mothers, Get Babies to the Breast Faster, UNICEF Says”

“More than half of newborns not breastfed in first hour raising health risks – UNICEF”

“77 million newborns globally not breastfed within first hour of life: UNICEF”

“Uno de cada dos bebés no toman leche materna al nacer”

“Lagging Worldwide Breastfeeding Rates Keep Newborn Lives At Risk”

“Delaying Breastfeeding At Birth Increases Risk Of Newborn Death By 80%: UN” (highly cited article)

“Les selfies d’allaitement maternel plébiscités par les Nations unies”

“Le lait maternel, « premier vaccin des nouveau-nés », selon l’Unicef”

“UNICEF Promosikan 'Brelfie', Dukung Menyusui di Ruang Publik”

“How Important Is Breastfeeding An Hour After Birth? 6 Facts Revealed In New UNICEF Study”

“Babies breastfed within an hour of birth are less likely to die. Yet only 50% are”

Communication for behavior and social change Example from Alive & Thrive projects

Interpersonal communication and mass communication had a combined and mutually

reinforcing impact

Country examples

Investments in effective legislation, community-based promotion and communication strategies, and the provision of skilled counselling and support at scale led to: Significant increase in national EBF rates in Burkina

Faso, Guinea Bissau, Kenya, Timor Leste and Zambia Increased Early Initiation rates in Cambodia, India,

Rwanda, Serbia, etc. Ongoing efforts Nigeria c-IYCF counseling package (GoN, USAID- SPRING,

UNICEF)


Examples from selected countries

Lack of political commitment and investment Lack of unified voice Fragmented programs Alignment of BF data with standard global

indicators; frequency of surveys Pressure from infant formula companies Emergency situations

Challenges

TIME TO ACT:

Global

Breastfeeding

Advocacy

Initiative

Our vision: a world where all women & families are empowered & supported to breastfeed


• Foster leadership and alliances and effectively integrate and communicate BF messages

• Mobilize resources and promote accountability

• Build knowledge and evidence

Breastfeeding Advocacy Initiative Strategic Goals


Key Achievements


Partnership is growing –

Call to Action - 7 Policy Asks 1/2


1. Increase funding to reach the 2025 WHA global target: raise the rate of exclusive breastfeeding in the first six months to at least 50 per cent.

2. Fully implement the International Code of Marketing of Breastmilk Substitutes and relevant World Health Assembly resolutions, through strong legal measures that are monitored, free from commercial influence, and enforced.

3. Enact family leave and workplace breastfeeding policies building on the International Labour Organization’s maternity protection guidelines, including provisions for the informal sector.

Call to Action – 7 Policy Asks 2/2


4. Implement the Ten Steps to Successful Breastfeeding in maternity facilities, including providing breastmilk for sick and vulnerable newborns.

5. Improve access to skilled lactation counselling as part of comprehensive breastfeeding policies and programmes in health facilities.

6. Strengthen links between health facilities and communities, and encourage community networks that protect, promote, and support breastfeeding.

7. Create monitoring systems that track the progress of policies, programmes, and funding towards achieving both national and global breastfeeding targets.

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Global Score Card


Breastfeeding provides substantial benefits for women and children in high- and low-income countries alike

Breastfeeding is a fundamental driver in achieving the SDGs and one of the smartest investments a country can make

Success is possible but it requires government leadership to make BF a policy priority, increase investment and work with communities and families.

Promoting and supporting breastfeeding is a collective societal responsibility: BAI has put forth a collective call to action with 7 policy asks to governments, donors and policy makers… Join us!

Conclusions

THANK YOU!

Documents

Click to edit Master title style By France Bégin, Ph.D ... · nouveau-nés », selon l’Unicef ” “UNICEF Promosikan 'Brelfie', Dukung Menyusui di Ruang Publik” “How Important